E-cigarette Explosion Injuries due to Lithium-Battery Overheating

E-cigarette Explosion Injuries to Face, Hands, and Thighs

Vaping e-cigarette may cause e-cigarette explosion

A person vaping e-cigarette.

The use of e-cigarettes is increasing among current, former, and never smokers. Components include an aerosol generator, a flow sensor, a battery, and a solution storage area. Many users do not understand the risk of “thermal runaway,” whereby internal battery overheating causes a battery fire or explosion.
Components of an e-cigarette

Components of an e-cigarette

Elisha G. Brownson, M.D., and colleagues at the University of Washington Medical Center in Seattle described injuries to 15 patients from e-cigarette explosions due to the lithium-ion battery component between October 2015 through June 2016. The letter to the Editor was published in the October 6 issue of the New England Journal of Medicine. The e-cigarette explosion injuries included flame burns (80%), chemical burns (33%), and blast injuries (27%) to the face, hands, and thighs. Blast injuries have led to tooth loss, traumatic tattooing, and extensive loss of soft tissue, requiring surgery.   The flame-burn injuries have required extensive wound care and skin grafting, and exposure to the alkali chemicals released from the battery explosion has caused chemical skin burns requiring wound care. Many of injuries occurred in young individuals. E-cigarettes are largely unregulated. Recently, the FDA has extended regulatory authority to cover all tobacco products, including e-cigarettes. Although these explosions were previously thought to be isolated events, the injuries among the 15 patients in Seattle add to growing evidence that e-cigarettes are a public safety concern. Both e-cigarette users and health care providers need to be aware of the risk of explosion associated with e-cigarettes.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.